Provider Demographics
NPI:1013427244
Name:BACHRACH, SUSAN LANKFORD (MA)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LANKFORD
Last Name:BACHRACH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 865
Mailing Address - Street 2:FLORIDA PSYCHOLOGY SERVICES, LLC
Mailing Address - City:APALACHICOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32320
Mailing Address - Country:US
Mailing Address - Phone:407-267-1060
Mailing Address - Fax:850-653-1602
Practice Address - Street 1:192 COACH WAGNER BLVD
Practice Address - Street 2:FLORIDA PSYCHOLOGY SERVICES
Practice Address - City:APALACHICOLA
Practice Address - State:FL
Practice Address - Zip Code:32320
Practice Address - Country:US
Practice Address - Phone:407-267-1060
Practice Address - Fax:850-653-1602
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRMH1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health